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Internship Application Form

 

STATE OF CONNECTICUT
Department of Consumer Protection
450 Columbus Blvd., Suite 901
Hartford, CT 06103

INTERNSHIP APPLICATION FORM

Name:____________________________________________________________
Address: __________________________________________________________
City:________________________   State:__________  Zip Code: ____________
School: ____________________________________________________________
Telephone:___________________                E-mail:______________________

Check one: Undergraduate___ Graduate___    High School ___

For credit? Yes___ No___

If you would like to receive credit, please list any requirements that your school has:

Please specify which division you are interested in working with:__________________
List major: ______________________      Available  start date:________________

Hours and days available:

Monday
Hours: 
Tuesday
Hours: 
Wednesday
Hours: 
Thursday
Hours: 
Friday Hours: 
         

 Along with this application please send your resume and a cover letter to:

Catherine Blinder, Catherine.Blinder@ct.gov